Organization
FAYETTE MEDICAL CENTER DME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KERI HENLEY HINDMAN (PATIENT ACCOUNTS DIRECTOR)
(205) 759-7378
Entity
Organization
Contact information
Practice address
411 FAYETTE SQ, FAYETTE, AL 35555-1723
(205) 932-5221
(205) 932-8054
Mailing address
PO BOX 710, 1653 TEMPLE AVENUE NORTH, FAYETTE, AL 35555-0710
(205) 932-5221
(205) 932-8054
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
009600310
—
AL
01
—
510-96182
BLUE CROSS
AL
Enumeration date
10/24/2006
Last updated
04/22/2022
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